Abstract
Authors: Sydni Au Hoy, BS (1), Carlie J. Arbaugh, MD (1), Caitlin P. Bungo, BS (1), Amanda J. Deutsch, MD (2), Bonnie E. Chow, MD (1), Kristen Gallegos, RN (1), Nerissa Alansalon, RN (1), Emmanuel Jisrawi, RN (1), Al’ai Alvarez, MD (1), Brooke Gurland, MD (1) and Joseph D. Forrester, MD (1)
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Introduction: Recurrent exposures to adverse patient events, including death, affect all members of the care team and can have long-term effects on clinician performance, personal well-being, and patient safety. Recognizing the impact of patient deaths on care teams is essential to mitigating potential risks of increased clinician burnout. We share the outcomes of a three-month pilot wellness intervention implemented at a busy academic hospital, directed explicitly toward resuscitation care teams managing patients who die from traumatic injuries.
Approach: A collaborative group from Stanford’s Trauma Surgery, Emergency Department (ED), and well-being leadership developed an integrated workflow to connect with care team members after a resuscitation ending in patient death. Our 4-pronged approach included 1) an immediate pause and 2) a defusion session, 3) a direct email communication to extend peer support and mental health resources, and 4) an invitation to monthly grief counselor-facilitated healing sessions. Engagement was measured based on email responses and healing session attendance. At 3 months, 8 trauma mortalities were recorded, with 120 corresponding email communications sent to care team members. The average event-to-distribution time was 84 hours (SD = 52.9 hours). A total of 18 unsolicited positive email responses were documented, in addition to the reception of verbal in-person feedback. Three monthly counselor-facilitated healing sessions occurred with 15, 10, and 9 individuals in attendance, respectively.
Discussion: Trauma-associated death is not uncommon, yet it often occurs without organized support systems for care teams. Our 4-pronged approach demonstrated the feasibility and considerable interest of medical professionals in a team-based and institution-driven effort to streamline resources and create spaces for facilitated peer-to-peer discussions. Further investigation is needed to understand the sustainability of offering consistent opportunities for healing support across all healthcare professions.
Affiliation:
- Stanford University
- Thomas Jefferson University and Hospitals